Doctors try a controversial technique to reduce the transplant organ shortage

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Doctors try a controversial technique to reduce the transplant organ shortage
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Doctors say they can boost the odds donated organs will be usable by restarting blood circulation with a pump after donors are declared dead. Critics say the procedure blurs the definition of death.

Dr. Marty Sellers, wearing a red scrub cap, and his team from Tennessee Donor Services perform a normothermic regional perfusion organ recovery at a hospital in eastern Tennessee.It’s late on a Friday afternoon at the Nashville International Airport when Dr. Marty Sellers hops out of a van and strides towards a small private jet idling on the runway."It replenishes the oxygen deprivation that the organs incur during the dying process," says Sellers.

"So when we put them on ice to be transported to the recipient center, the organs are in a healthier state and therefore when they get into the recipient they perform better immediately and long term," Sellers says. "The worry is if there were some brain blood flow that certain parts of the brain could potentially continue functioning and then the person wouldn't be dead," says Dr., a professor emeritus of neurology at Dartmouth Geisel School of Medicine."I don't think it would be conceivable that they would be awake. But from a point of view of 'Is the donor dead or not?' it would require zero blood flow to the brain to prove that.

The team retreats to a nearby office to wait and orders a takeout dinner. Finally, several hours later, it looks like one of the operating rooms will open up. So the team heads back to the hospital to change into scrubs and camp out in a surgeons lounge, where a panel of video screens on the wall show what's happening in each operating room.Karen"Susie" Phillips, right, suffered a head injury in a car accident that made her a candidate for organ donation.

"The two nurses will say: 'She has passed,'"Howell says."We’ll utilize the five minutes of observation time to roll in here. The nurses will make sure at that five-minute mark that there’s been no autoresuscitation. And then will move forward with the recovery." It’s well past midnight when the team gets word that the donor’s breathing tube has been removed, starting the 90-minute clock ticking.

The 90-minute mark quietly passes. The organ retrieval is canceled. The patient is wheeled back into her hospital room. This case illustrates the many ways it’s so hard to get enough organs for transplantation, despite everyone’s best efforts. It also shows why some doctors like Sellers are trying everything they can to improve the odds.

Sellers and his organ recovery team flew in from Nashville this morning to try again to retrieve a liver and two kidneys from another donor. Finally, about a half-hour later the right saw arrives. The donor’s bed is wheeled from intensive care to a room near the operating room. That’s where her life support will be withdrawn and the family can say goodbye."The family has the desire for her to be an organ donor, and really couldn’t think of a better way to end the chapter in her life than to extend her legacy and save the lives of others," says Randall Statzer, an organ recovery coordinator with the Tennessee Donor Services.

The pump is finally on, restoring circulation to the abdominal organs. Sellers starts working to remove the liver and kidneys. But he quickly discovers bad news.

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